| NPI | 1487154936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 169122) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 165523) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2019-06-17 |